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41. Journal of Public and International Affairs 2015

Author:
Joanna Hecht, Sam duPont, Cynthia Barmore, Natasha Geber, Abby McCartney, Emily A. Wiseman, Jordan Dantas, Stephanie Leutert, and Lauren Dunn
Publication Date:
05-2015
Content Type:
Journal Article
Journal:
Woodrow Wilson School Journal of Public and International Affairs
Institution:
Woodrow Wilson School of Public and International Affairs, Princeton University
Abstract:
Cynthia Barmore builds on primary survey research conducted in Bosnia and Herzegovina to offer new explanations of the constraints placed on farmers by an unreformed land system. Natasha Geber addresses an underexplored policy area, looking at Russia’s geopolitical ambitions in the Arctic and offering a perspective on the chances of international cooperation on Arctic issues. Abby McCartney pulls together two seemingly disparate policies, seeing an opportunity for New Jersey to expand its successful drug court program using provisions of the Affordable Care Act. Emily Wiseman looks at how women and girls still tend to be excluded from post-disaster relief efforts, even though almost all implementers understand that this exclusion exacerbates gender inequality and retards reconstruction. Jordan Dantas analyzes the drop in piracy off the Somali coast, and finds private sector success where military solutions failed. Stephanie Leutert offers a clear-eyed perspective on the divergent narratives about the Obama Administration’s deportation policies, and analyzes how those policies have impacted immigrant communities. Lauren Dunn looks at two programs for using mobile phones to provide basic banking services—a success and a failure—and offers lessons for how the regulatory environment and existing institutions must shape program design.
Topic:
Security, Gender Issues, Government, Immigration, Piracy, Women, Conflict, Rural, Drugs, Land Rights, Barack Obama, and Medicaid
Political Geography:
Russia, India, Haiti, North America, Somalia, Arctic, United States of America, and Bosnia and Herzegovina

42. Quality and Accountability in Healthcare Delivery: Audit Evidence from Primary Care Providers in India

Author:
Jishnu Das, Alaka Holla, Aakash Mohpal, and Karthik Muralidharan
Publication Date:
02-2015
Content Type:
Working Paper
Institution:
Centre for Policy Research, India
Abstract:
We present among the first direct evidence on the quality of healthcare in low-income settings using a unique and original set of audit studies, where standardized patients were presented to a nearly-representative sample of rural public and private primary care providers in the Indian state of Madhya Pradesh. We report three main findings. First, private providers are mostly unqualified but spent more time with patients, and completed more items on a checklist of essential history and examination items than public providers, while being no different in their diagnostic and treatment accuracy. Second, we identify the private practices of qualified public sector doctors, and show that the same doctors exert higher effort and are more likely to provide correct treatment in their private practices. Third, we find a strong positive correlation between provider effort and prices charged in the private sector, whereas we find no correlation between effort and wages in the public sector. Our results suggest that market-based accountability in the unregulated private sector may be providing better incentives for provider effort than administrative accountability in the public sector in this setting. While the overall quality of care is low in both the public and private sectors, these differences in provider effort may partly explain the dominant market share of fee-charging private providers even in the presence of a system of free public healthcare.
Topic:
Government, Health, Privatization, Health Care Policy, Social Policy, and Rural
Political Geography:
South Asia, India, and Asia

43. Healthcare-Seeking Practices of African and Rural-to-Urban Migrants in Guangzhou

Author:
Tabea Bork-Huffer
Publication Date:
12-2015
Content Type:
Journal Article
Institution:
German Institute of Global and Area Studies
Abstract:
Taking the examples of Chinese rural-to-urban migrant and African migrant businesspeople in Guangzhou, this article inquires into the commonalities and differences in the health status and health- care-seeking practices of both groups. While both populations of migrants are diverse and heterogeneous, there are many commonali- ties with regard to the challenges they face compared to the Chinese local population. Mixed-methods research frameworks and qualitative and quantitative methods were applied. While existing publications emphasise lacking financial access to healthcare, further individual and social factors account for migrants’ healthcare choices. Their access to healthcare can be improved only by introducing insurance schemes with portable benefits, providing localised and culturally adequate health services adapted to migrants’ specific needs and health risks, and enhancing patient orientation and responsiveness by health professionals.
Topic:
Migration, Health Care Policy, Urban, and Rural
Political Geography:
Africa, China, and Asia